pharmaceuticals provision of pharmacy services in conus

Defense Health ProgramFiscal Year (FY) 2016 Budget Estimates

Operation and MaintenanceIn-House Care

In-House CareIHC-1

I. Description of Operations Financed: This Budget Activity Group provides the delivery of patient care in the Continental United States (CONUS) and Outside the Continental United States (OCONUS). This program includes the following:

Care in Department of Defense Medical Centers, Hospitals and Clinics - Resources medical care in CONUS and OCONUS facilities which are staffed and equipped to provide inpatient and outpatient care for both surgical and medical conditions for Military Health System beneficiaries.

Dental Care - Resources dental care and services in CONUS and OCONUS for authorized personnel through the operation of hospital departments of dentistry, installation dental clinics and regional dental activities.

Pharmaceuticals - Resources pharmaceuticals specifically identified and measurable to the provision of pharmacy services in CONUS and OCONUS facilities.

II. Force Structure Summary: The In-House Care Budget Activity Group includes staffing to provide medical and dental care in military facilities which provide the full range inpatient and ambulatory medical and dental care services. In addition to medical and dental care, this Budget Activity Group also includes medical center laboratories, substance abuse programs, facility on-the-job training/education programs and federal health care sharing agreements. This Budget Activity Group excludes operation of management headquarters for TRICARE Regional Offices, deployable medical and dental units and health care resources devoted exclusively to teaching.



III. Financial Summary ($ in thousands)

In-House CareIHC-2

FY 2015Congressional Action

A. BA SubactivitiesFY 2014 Actual

Budget Request Amount Percent Appropriated

Current Estimate

FY 2016 Estimate

1. MEDCENs, Hospitals & Clinics (CONUS)

6,136,439 6,111,692 -107,131 -1.8 6,004,561 6,004,561 6,442,816

2. MEDCENs, Hospitals & Clinics (OCONUS)

427,103 472,527 0 0.0 472,527 472,527 503,688

3. Pharmaceuticals (CONUS) 1,392,576 1,527,596 -26,715 -1.8 1,500,881 1,500,881 1,480,3234. Pharmaceuticals (OCONUS)

119,662 142,889 0 0.0 142,889 142,889 132,683

5. Dental Care (CONUS) 428,553 481,951 0 0.0 481,951 481,951 461,6476. Dental Care (OCONUS) 46,906 62,431 0 0.0 62,431 62,431 61,141Total 8,551,239 8,799,086 -133,846 -1.5 8,665,240 8,665,240 9,082,2981. FY 2014 actuals include $352.2M for Overseas Contingency Operations (OCO).2. FY 2014 does not reflect Department of Defense (DoD) Medicare-Eligible Retiree Health Care Fund (MERHCF) of $1,361.3M (O&M only).3. FY 2014 Omnibus Reprogramming -$255.0M (In-House Care, Base) to Procurement, and -$14.9M (In-House Care, OCO) to DoD. Total Omnibus Reprogramming from the In-House Care Budget Activity Group was -$269.9M.4. FY 2015 estimate excludes $65.9M for OCO.5. FY 2015 does not reflect DoD MERHCF of $1,400.7M (O&M only).6. FY 2016 request excludes OCO.7. FY 2016 does not reflect DoD MERHCF of $1,444.0M (O&M only).




In-House CareIHC-3

B. Reconciliation SummaryChange

FY 2015/FY 2015Change

FY 2015/FY 2016Baseline Funding 8,799,086 8,665,240Congressional Adjustments (Distributed) -118,116Congressional Adjustments (Undistributed)Adjustments to Meet Congressional IntentCongressional Adjustments (General Provisions) -15,730Subtotal Appropriated Amount 8,665,240Fact-of-Life Changes (2015 to 2015 Only)Subtotal Baseline Funding 8,665,240Supplemental 65,902ReprogrammingsPrice Changes 203,667Functional Transfers -818Program Changes 214,209Current Estimate 8,731,142 9,082,298Less: Wartime Supplemental -65,902Normalized Current Estimate 8,665,240




In-House CareIHC-4

C. Reconciliation of Increases and Decreases Amount TotalsFY 2015 President's Budget Request (Amended, if applicable) 8,799,0861. Congressional Adjustments -133,846

a. Distributed Adjustments1) One-Time Congressional Increase for SOCOM Behavioral

Health.14,800

2) One-Time Congressional Increase for CVN-73 Refueling and Remodeling.

8803) One-Time Congressional Decrease for Army Identified

Excess.-76,000

4) One-Time Congressional Decrease for Benefit Reform Proposal (Consolidation of TRICARE Prime).

-30,0005) One-Time Congressional Decrease for Pharmacy Benefit

Reform Proposal.-26,715

6) One-Time Congressional Decrease for NICOE Satellite Overstated Growth.

-7047) One-Time Congressional Decrease for FECA Expense

Transfer not properly accounted for.-377

b. Undistributed Adjustmentsc. Adjustments to Meet Congressional Intentd. General Provisions

1) Section 8080 - Decrease for Favorable Foreign Currency Exchange Rates.

-15,730FY 2015 Appropriated Amount 8,665,2402. OCO and Other Supplemental Enacted 65,902

a. OCO and Other Supplemental Requested1) OCO 65,902

3. Fact-of-Life ChangesFY 2015 Baseline Funding 8,731,1424. Reprogrammings (Requiring 1415 Actions)Revised FY 2015 Estimate 8,731,142




In-House CareIHC-5

C. Reconciliation of Increases and Decreases Amount Totals5. Less: OCO and Other Supplemental Appropriations and

Reprogrammings (Items 2 and 4)-65,902

FY 2015 Normalized Current Estimate 8,665,2406. Price Change 203,6677. Functional Transfers -818

a. Transfers Inb. Transfers Out

1) Transfer of Advanced Life Support Services (ALS) from Naval Hospital (NH) Lemoore to Commander, Navy Region Southwest (CNRSW) Fire and Emergency Services (F&ES):

-818

Transfers funding from the Defense Health Program to Navy for provision of ALS Services. Naval Air Station Lemoore F&ES, organized as part of the CNRSW F&ES, will provide ALS ambulance services to areas previously covered by the ALS contract service provided by NH Lemoore. The action ensures continuation of required capabilities while eliminating duplication of effort and providing more efficient use of resources.

8. Program Increases 385,273a. Annualization of New FY 2015 Programb. One-Time FY 2016 Increases

1) Reversal of FY 2015 One-Time Congressional Decrease (Army Identified Excess).

77,7482) Reversal of FY 2015 One-Time Congressional Decrease

(Benefit Reform - Consolidation of TRICARE Prime).30,690

3) Reversal of FY 2015 One-Time Congressional Decrease (Pharmacy Benefit Reform).

27,3294) Reversal of FY 2015 General Provisions (Section 8080

- Favorable Foreign Currency Exchange Rates).16,092




In-House CareIHC-6

C. Reconciliation of Increases and Decreases Amount Totals5) Reversal of FY 2015 One-Time Congressional Decrease

(NICOE Satellite Overstated Growth).720

6) Reversal of FY 2015 One-Time Congressional Decrease (FECA Expense Transfer-- Not Properly Accounted For).

386c. Program Growth in FY 2016

1) Equipment - Air Force Medical Service (AFMS): 45,659 Internal funding realignment by the AFMS from

pharmacy to equipment to improve the organization's life-cycle replacement rate. The FY 2015 In-House Care equipment baseline funding is $334.1M.

2) FY 2015 Health Benefit Reform - Refills of Maintenance Medications Through Military Treatment Facility (MTF) Pharmacies or National Mail-Order Pharmacy Program:

36,490

Provides additional pharmacy funds for projected increased demand within the MTF pharmacies based on a policy change outlined in the FY 2015 National Defense Authorization Act, Section 702 which requires eligible beneficiaries to refill non-generic prescription maintenance medications through MTF pharmacies (In-House Care Budget Activity Group) or the National Mail-Order Pharmacy Program (Private Sector Care Budget Activity Group). The FY 2015 In-House Care pharmacy baseline funding is $1,643.8M.

3) FY 2016 Health Benefit Reform - Pharmacy Co-Pays: 30,528 Provides additional pharmacy funds for projected

increased demand within the MTF pharmacies due to an expected shift in beneficiaries' preference for MTF pharmacies as a result of proposed legislation increasing retail pharmacy co-pays. The FY 2015 In-




In-House CareIHC-7

C. Reconciliation of Increases and Decreases Amount TotalsHouse Care pharmacy baseline funding is $1,643.8M.

4) FY 2016 Health Benefit Reform - Consolidated Health Plan Proposal:

29,719 Start-up costs to consolidate the TRICARE health plan

into a single plan to replace the current TRICARE Prime, Standard and Extra health insurance-like plans. This new plan will allow for better management of healthcare by building a shared commitment with our beneficiaries by providing greater choice and flexibility in their healthcare benefit. The FY 2015 In-House Care Continental United States (CONUS) Medical Care baseline funding is $6,004.6M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

5) Healthcare Services - Air Force Medical Service (AFMS):

18,618 Realigns funding from the IM/IT and Education and

Training Budget Activity Groups to purchase approximately 180 contract providers and support staff to enable the AFMS to maintain services at Military Treatment Facilities, thereby mitigating the impact of patients seeking care in the private sector. The FY 2015 Air Force In-House Care baseline funding is $1,433.8M. The FY 2015 Air Force In-House Care baseline staffing is 4,925 civilian FTEs and 2,875 contractors.

6) Clinical Pharmacists and Telehealth Services: 17,250 Realigns funding from the Consolidated Health Support

Budget Activity Group to the In-House Care Budget Activity Group for contract clinical pharmacists and




In-House CareIHC-8

C. Reconciliation of Increases and Decreases Amount Totalsequipment to enhance the capability to more efficiently provide telehealth consultations over a greater geographic area. The FY 2015 Army In-House Care baseline funding is $4,356.9M. The FY 2015 Army In-House Care baseline staffing is 32,343 civilian FTEs and 4,945 contractors.

7) Increased Supply Requirements - Air Force Medical Service (AFMS):

17,167 Provides additional funding for supplies to match the

level required to support healthcare services based on an AFMS reconciliation of budget requirements against actual execution. The FY 2015 Air Force In-House Care supplies baseline funding is $39.7M.

8) One More Civilian Paid Day: 16,090 Adjusts civilian payroll for one additional pay day

in FY 2016. The FY 2015 In-House Care civilian pay baseline funding is $4,138.4M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs.

9) Travel: 8,613 This funding is for emerging world-wide healthcare

support requirements, continuing education for clinical currency of DoD mission, and Military Health System staff credentialing requirements. The FY 2015 In-House Care travel baseline funding is $64.5M.

10) Initial Outfitting and Transition (IO&T): 7,619 Incremental funding to support IO&T requirements for

programmed projects such as the Pope Dental Clinic Repair at Fort Bragg, NC; Clinic Modernization at Minot Air Force Base, ND; Restoration of Pharmacies at Naval Hospital, Bremerton, WA; Dental/Medical




In-House CareIHC-9

C. Reconciliation of Increases and Decreases Amount TotalsClinic Replacement at Spandahlem Air Base, Germany; Labor & Delivery Modernization at Eglin Air Force Base, FL; and Patient Centered Medical Home Reconfiguration at Fort Benning, GA. The FY 2015 In-House Care IO&T baseline funding is $220.0M.

11) Tri-Service Workflow (TSWF) and Content Advisory Group (CAG):

4,555 Funds expansion of ongoing TSWF and CAG efforts to

standardize the provision of quality health care services and the associated electronic clinical documentation through standardized electronic patient documentation templates. These standardized templates simultaneously enhance provider efficiency and patient safety by influencing provider workflow, while standardizing the clinical notes to facilitate continuity of care. By directing patient care through evidence based guidelines, the templates advocate for appropriate patient care and result in a cost avoidance to the Military Health System. Clinical teams in the outpatient setting utilizing these templates have shown better clinical results in mental health, MRIs, heart attack and stroke, reducing unnecessary hospitalization, procedures and improving patient compliance resulting in significant cost avoidance. The FY 2015 Continental United States (CONUS) Medical Care baseline funding is $6,004.6M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

9. Program Decreases -171,064




In-House CareIHC-10

C. Reconciliation of Increases and Decreases Amount Totalsa. Annualization of FY 2015 Program Decreasesb. One-Time FY 2015 Increases

1) Reversal of FY 2015 One-Time Congressional Increase (SOCOM Behavioral Health).

-15,1402) Reversal of FY 2015 One-Time Congressional Increase

(CVN-73 Refueling and Remodeling).-900

c. Program Decreases in FY 20161) Pharmacy Realignment - Air Force Medical Service

(AFMS):-99,687

Internal realignments by the AFMS within the In-House Care Budget Activity Group from pharmacy to equipment and medical care contracts in support of direct patient care. The FY 2015 Air Force In-House Care pharmacy baseline funding is $532.9M.

2) Defense Health Agency Shared Services' Savings - Pharmacy and Medical Logistics (MEDLOG):

-21,012 Savings of $11.8M due to the Pharmacy Shared Service

(from centralized drug purchasing rules, formulary management, suspending coverage of newly approved FDA drugs and centralization of pharmacy automation contracts); and $9.2M in savings due to the MEDLOG Shared Service (from a focus on Supply Management,Equipment Management and MEDLOG Services). The consolidation of like services across the Military Health System will produce savings by reducing redundancies and consolidating key functional and business support areas. The FY 2015 Defense Health Program In-House Care baseline funding is $6,477.1M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678




In-House CareIHC-11

C. Reconciliation of Increases and Decreases Amount Totalscontractors.

3) Support Operation of Defense Health Agency Shared Service - Health Information Technology (HIT):

-17,799 Realigns funding to the IM/IT Budget Activity Group

in support of the organization of HIT. Funding is realigned for supplies, travel and contract support related to Information Management that transitions from the Components to the Defense Health Agency to enable the Shared Service to achieve the planned cost reductions. The FY 2015 In-House Care baseline funding is $6,477.1M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

4) Temporary Disability Retirement List (TDRL): -7,521 Realigns funding to the Consolidated Health Support

Budget Activity Group to expedite service member medical status determinations for those members that have been placed on the TDRL due to a long-lasting or permanent change from a wound, illness or injury by reducing the cycle time of the two evaluation boards reviewing a Service member's case file documentation. A Medical Evaluation Board (MEB) will review the Service member's record to decide if he/she meets medical retention standards. After the MEB, a Physical Evaluation Board will be convened to determine the Service member's disposition—return to duty, separation or retirement, either permanent or temporary. The FY 2015 In-House Care baseline funding is $6,477.1M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678




In-House CareIHC-12

C. Reconciliation of Increases and Decreases Amount Totalscontractors.

5) Traumatic Brain Injury/Psychological Health (TBI/PH) and Wounded, Ill and Injured (WII):

-6,290 Resource requirements have decreased for the TBI/PH

and WII programs. Current data shows the number of redeployments have dropped by 26% with a corresponding decrease in associated workload. The FY 2015 In-House Care baseline funding is $6,477.1M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

6) Civilian Human Resources Service Center (CHRSC): -1,600 Realigns funding from Navy's - Defense Health Program

(Bureau of Medicine and Surgery) In-House Care Budget Activity Group to the Defense Health Agency - National Capital Region Medical Directorate's Base Operations/Communications Budget Activity Group in support of the CHRSC. The FY 2015 Continental United States (CONUS) Medical Care baseline funding is $6,004.6M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

7) 20% Headquarters Reduction: -1,007 Continuation of incremental 20% reduction to Defense

Health Program headquarters in compliance with the Department of Defense July 31, 2013 memorandum, "20% Headquarters Reduction," signed by the Deputy Secretary of Defense. For the In-House Care Budget Activity Group, the reductions are primarily in contract personnel. The FY 2015 Continental United States (CONUS) Medical Care baseline funding is




In-House CareIHC-13

C. Reconciliation of Increases and Decreases Amount Totals$6,004.6M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

8) Support Operation of Defense Health Agency Shared Service - Medical Logistics (MEDLOG):

-108 Realigns funding to the Consolidated Health Support

Budget Activity Group in support of the MEDLOG Shared Service. Funding is realigned to support the transition of one civilian FTE to the Shared Service. The FY 2015 In-House Care baseline funding is $6,477.1M. The FY 2015 In-House Care baseline staffing is 48,874 civilian FTEs and 13,678 contractors.

FY 2016 Budget Request 9,082,298



IV. Performance Criteria and Evaluation Summary:

In-House CareIHC-14

Population by Service - World Wide* Change Change

FY 2014 FY 2015 FY 2016FY

2014/2015FY

2015/2016Average Eligible PopulationCatchment AreaArmy 1,839,785 1,753,268 1,717,596 -86,517 -35,672Coast Guard 67,821 66,328 65,795 -1,493 -533Air Force 891,788 855,272 858,520 -36,516 3,248Marine Corps 442,367 431,459 429,337 -10,908 -2,122Navy 855,098 822,092 828,555 -33,006 6,463Navy Afloat 253,485 250,473 254,677 -3,012 4,204Other/Unknown 20,924 28,356 30,154 7,432 1,798Subtotal 4,371,268 4,207,248 4,184,634 -164,020 -22,614




In-House CareIHC-15

Change Change

FY 2014 FY 2015 FY 2016FY

2014/2015FY

2015/2016Non-Catchment AreaArmy 2,028,198 1,972,396 1,968,613 -55,802 -3,783Coast Guard 145,281 142,140 141,321 -3,141 -819Air Force 1,710,269 1,661,999 1,670,693 -48,270 8,694Marine Corps 301,218 290,426 290,338 -10,792 -88Navy 893,654 864,168 869,017 -29,486 4,849Navy Afloat 53,185 52,590 53,443 -595 853Other/Unknown 31,406 38,986 40,878 7,580 1,892Subtotal 5,163,211 5,022,705 5,034,303 -140,506 11,598




In-House CareIHC-16

Change ChangeFY 2014 FY 2015 FY 2016

FY 2014/2015

FY 2015/2016

Total Average Eligible PopulationArmy 3,867,983 3,725,664 3,686,209 -142,319 -39,455Coast Guard 213,102 208,468 207,116 -4,634 -1,352Air Force 2,602,057 2,517,271 2,529,213 -84,786 11,942Marine Corps 743,585 721,885 719,675 -21,700 -2,210Navy 1,748,752 1,686,260 1,697,572 -62,492 11,312Navy Afloat 306,670 303,063 308,120 -3,607 5,057Other/Unknown 52,330 67,342 71,032 15,012 3,690Total 9,534,479 9,229,953 9,218,937 -304,526 -11,016*Note: The data are derived from DEERS (December 2014). Numbers may not sum to totals due to rounding.

DHP Requirements (in millions of dollars) 30,219.2 30,012.0 30,889.9 -207 878Beneficiaries (000's) 9,534 9,230 9,219 -304 -11Enrollees (000's) 3,231 3,390 3,429 159 39




In-House CareIHC-17

Direct Care System Workload* Change ChangeFY 2014 FY 2015 FY 2016

FY 2014/2015

FY 2015/2016

Inpatient Admissions, Non-Weighted (SIDR Dispositions-All) 258,261 244,900 247,084 -13,361 2,185Inpatient Admissions, Weighted (MS-DRG RWPs, Non Mental Health) 207,956 215,050 217,067 7,094 2,018Inpatient Admissions, Occupied Bed Days (Mental Health Only) 87,259 89,297 91,795 2,038 2,498Average length of Stay (All Bed Days/ All Dispositions-All Diagnosis) 3.15 3.03 3.07 -0.12 0.04Ambulatory Visits, Non-Weighted (Encounters, CAPER) 38,188,888 39,099,293 39,573,218 910,405 473,925Ambulatory Visits, Weighted (Adj Provider Aggregate RVUs, CAPER) 80,074,777 84,396,247 85,369,983 4,321,471 973,736Ambulatory Procedures, Weighted (Aggregate Weight APCs, CAPER)

11,006,494 10,548,774 10,607,991 -457,721 59,217Pharmacy (Number of Prescriptions Filled) 47,471,897 47,726,048 47,648,773 254,151 -77,275




In-House CareIHC-18

Dental Workload (Dental Weighted Values (DWVs)*

Change Change

FY 2014 FY 2015 FY 2016FY

2014/2015FY

2015/2016CONUS 12,218,127 13,740,506 13,162,030 1,522,379 -578,476OCONUS 2,932,028 3,902,529 3,821,746 970,501 -80,783 Total DWVs 15,150,155 17,643,035 16,983,776 2,492,880 -659,259

CONUSActive Duty 9,685,520 10,892,336 10,433,768 1,206,816 -458,568Non-Active Duty 2,532,607 2,848,170 2,728,262 315,563 -119,908 Total CONUS 12,218,127 13,740,506 13,162,030 1,522,379 -578,476

OCONUSActive Duty 2,015,363 2,682,448 2,626,921 667,085 -55,527Non-Active Duty 916,665 1,220,081 1,194,825 303,416 -25,256 Total OCONUS 2,932,028 3,902,529 3,821,746 970,501 -80,783*Note: (1) FY 2014 Direct Care Workload data are from M2 and FY 2015-2016 data are from Service Business Plans; (2) Dental Workload data provided by Service Dental Treatment Commands.



In-House CareIHC-19

V. Personnel Summary FY 2014 FY 2015 FY 2016Change

FY 2014/FY 2015

ChangeFY 2015/FY 2016

Active Military End Strength (E/S) (Total) 46,705 46,028 45,674 -677 -354Officer 17,042 16,889 16,765 -153 -124Enlisted 29,663 29,139 28,909 -524 -230

Active Military Average Strength (A/S) (Total)

46,546 46,367 45,851 -179 -516Officer 17,016 16,966 16,827 -50 -139Enlisted 29,530 29,401 29,024 -129 -377

Civilian FTEs (Total) 43,588 48,874 48,059 5,286 -815U.S. Direct Hire 42,190 47,225 46,396 5,035 -829Foreign National Direct Hire 573 609 609 36 0Total Direct Hire 42,763 47,834 47,005 5,071 -829Foreign National Indirect Hire 825 1,040 1,054 215 14Memo: Reimbursable Civilians Included 103 207 207 104 0

Average Annual Civilian Salary ($ in thousands)

85.1 86.3 87.3 1.2 1.0

Contractor FTEs (Total) 13,453 13,678 13,105 225 -573

Explanation of changes in Active Military End Strength: The change from FY 2014 to FY 2015 (-677) includes Army internal reprogrammings (-70) and Navy reductions (-315) and Air Force reductions (-292) to meet requirements of the Budget Control Act. The change from FY 2015 to FY 2016 (-354) includes Army internal realignments (-6), Navy internal realignments (-6) and Air Force reductions (-342) to meet requirements of the Budget Control Act.



In-House CareIHC-20

Explanation of changes in Civilian FTEs: FY 2014-2015 change is not an increase in staffing, but a reflection of the FY 2014 Actuals executing at a lower level than what was programmed due to the impacts of Sequestration in FY 2013 followed by a furlough and Continuing Resolution in FY 2014. FY 2015-2016 decrease reflects actions from a civilian workforce analysis based on Department of Defense guidance to shape a properly sized and highly capable workforce.

Explanation of changes in Contractor FTEs: FY 2014-2015 change is not an increase in contractors, but similar to the civilians, a reflection of the FY 2014 Actuals executing at a lower level. FY 2015-2016 decrease reflects efforts to become more efficient in the reliance on contractor support via consolidation of requirements.



In-House CareIHC-21

VI. OP 32 Line Items as Applicable (Dollars in thousands):

FY 2014Foreign Currency

Change FY 2014/FY 2015 FY 2015

Foreign Currency


OP 32 Line Actual Rate Diff Price Program Estimate Rate Diff Price Program Estimate101 Exec, Gen’l & Spec Scheds 3,659,211 0 36,593 442,570 4,138,374 0 50,695 -74,473 4,114,596199 TOTAL CIV COMPENSATION 3,659,211 0 36,593 442,570 4,138,374 0 50,695 -74,473 4,114,596308 Travel of Persons 58,750 0 1,057 4,643 64,450 60 1,097 8,613 74,220

399 TOTAL TRAVEL 58,750 0 1,057 4,643 64,450 60 1,097 8,613 74,220401 DLA Energy (Fuel Products) 393 0 9 -82 320 0 -23 49 346402 Service Fund Fuel 3 0 0 33 36 0 -3 -24 9

411 Army Supply 0 0 0 5,047 5,047 0 129 -5,176 0412 Navy Managed Supply, Matl 588 0 7 -7 588 0 20 -8 600416 GSA Supplies & Materials 7,373 0 133 482 7,988 188 139 -138 8,177417 Local Purch Supplies & Mat 9,261 0 166 39,396 48,823 0 830 175 49,828422 DLA Mat Supply Chain (Medical)

18,837 0 -75 214 18,976 0 76 289 19,341

499 TOTAL SUPPLIES & MATERIALS

36,455 0 240 45,083 81,778 188 1,168 -4,833 78,301

502 Army Fund Equipment 4,984 0 63 -4,487 560 0 0 10 570503 Navy Fund Equipment 2,008 0 24 -1,833 199 0 0 4 203505 Air Force Fund Equip 53,473 0 0 -12,521 40,952 0 0 788 41,740506 DLA Mat Supply Chain (Const & Equip)

9,196 0 64 -5,658 3,602 0 36 -3,436 202

507 GSA Managed Equipment 2,709 0 49 7,502 10,260 0 174 -1,475 8,959599 TOTAL EQUIPMENT PURCHASES

72,370 0 200 -16,997 55,573 0 210 -4,109 51,674



In-House CareIHC-22



Foreign Currency


OP 32 Line Actual Rate Diff Price Program Estimate Rate Diff Price Program Estimate601 Army Industrial Operations

175 0 5 -180 0 0 0 0 0

611 Navy Surface Warfare Ctr 0 0 0 812 812 0 12 4 828633 DLA Document Services 1,046 0 59 654 1,759 0 -38 71 1,792677 DISA Telecomm Svcs - Reimbursable

206 0 16 -157 65 0 1 0 66

696 DFAS Financial Operation (Other Defense Agencies)

3,041 0 54 -3,095 0 0 0 0 0

699 TOTAL DWCF PURCHASES 4,468 0 134 -1,966 2,636 0 -25 75 2,686706 AMC Channel Passenger 117 0 2 -119 0 0 0 0 0719 SDDC Cargo Ops-Port hndlg 2 0 0 15 17 0 7 -4 20771 Commercial Transport 6,165 0 111 715 6,991 0 119 13 7,123799 TOTAL TRANSPORTATION 6,284 0 113 611 7,008 0 126 9 7,143901 Foreign National Indirect Hire (FNIH)

39,434 0 395 18,173 58,002 0 711 1,165 59,878

902 Separation Liab (FNIH) 3,013 0 30 -30 3,013 0 37 -37 3,013912 Rental Payments to GSA (SLUC)

820 0 15 -807 28 0 0 1 29

913 Purchased Utilities (Non-Fund)

1,770 0 32 7,438 9,240 0 157 62 9,459

914 Purchased Communications (Non-Fund)

1,852 0 33 4,137 6,022 0 102 9 6,133

915 Rents (Non-GSA) 12,733 0 229 4,975 17,937 0 305 2,190 20,432



In-House CareIHC-23



Foreign Currency


OP 32 Line Actual Rate Diff Price Program Estimate Rate Diff Price Program Estimate917 Postal Services (U.S.P.S)

1,084 0 19 -328 775 0 13 3 791

920 Supplies & Materials (Non-Fund)

762,752 0 28,222 -351,935 439,039 233 16,253 55,318 510,843

921 Printing & Reproduction 6,074 0 110 2,961 9,145 0 155 -117 9,183922 Equipment Maintenance By Contract

155,208 0 2,794 -36,361 121,641 0 2,068 12,824 136,533

923 Facilities Sust, Rest, & Mod by Contract

175,510 0 3,159 -40,195 138,474 0 2,354 371 141,199

924 Pharmaceutical Drugs

1,512,238 0 55,953 75,579 1,643,770 0 60,819 -91,583 1,613,006

925 Equipment Purchases (Non-Fund)

364,960 0 13,503 -100,208 278,255 49 10,297 40,870 329,471

930 Other Depot Maintenance (Non-Fund)

10 0 0 -10 0 0 0 0 0

932 Mgt Prof Support Svcs 8,437 0 152 2,317 10,906 0 185 -1,812 9,279933 Studies, Analysis & Eval 7,481 0 135 13,013 20,629 0 351 6,465 27,445934 Engineering & Tech Svcs 676 0 12 -688 0 0 0 0 0937 Locally Purchased Fuel (Non-Fund)

70 0 2 285 357 0 -26 60 391

955 Other Costs (Medical Care) 252,944 0 9,359 -53,498 208,805 1,568 7,784 90,016 308,173960 Other Costs (Interest and Dividends)

947 0 17 -964 0 0 0 0 0

964 Other Costs (Subsistence and Support of

4,220 0 76 -2,081 2,215 0 38 6 2,259



In-House CareIHC-24



Foreign Currency


OP 32 Line Actual Rate Diff Price Program Estimate Rate Diff Price Program EstimatePersons)986 Medical Care Contracts 1,097,159 0 40,594 -69,523 1,068,230 2,135 39,604 135,617 1,245,586987 Other Intra-Govt Purch 96,052 0 1,729 -24,721 73,060 0 1,242 570 74,872

988 Grants 2,584 0 47 -2,631 0 0 0 0 0989 Other Services 174,631 0 3,144 4,381 182,156 211 3,100 30,755 216,222990 IT Contract Support Services 31,042 0 559 -7,879 23,722 0 403 5,356 29,481999 TOTAL OTHER PURCHASES 4,713,701 0 160,320 -558,600 4,315,421 4,196 145,952 288,109 4,753,678Total 8,551,239 0 198,657 -84,656 8,665,240 4,444 199,223 213,391 9,082,298

pharmaceuticals provision of pharmacy services in conus

Documents